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In a Perfect World: The integration of conventional and integrative oncology

ConventionalvsIntegrativeby Jill Shainhouse, ND Fabno, CKN Section Editor

 

The lack of integration between the conventional and adjunctive oncology worlds in the Canadian system presents patients with a dilemma on many fronts.  The “perfect” system would be one that had all necessary professionals under one roof to manage oncology patients.  Currently, what exists are the Cancer Centres which are covered by provincial healthcare plans and should a patient choose to seek Adjunctive Naturopathic Care, the money comes out of their own pocket.

As a naturopathic doctor board certified in oncology, attempting to communicate with the professionals in Cancer Centres, I find that some oncologists and other healthcare practitioners in the field (social workers, dieticians, nurses, pharmacists) are more open to ND’s and their recommendations than others.

 

Why is this?

One concern is that medical professionals are unsure of who can call themselves an alternative healthcare practitioner and who cannot.  The cause for concern is that there are many alternative healthcare practitioners from all walks of life.  Naturopathic Oncologists must successfully undergo standardized training and testing.  FABNO certified ND’s (Fellow of the American Board of Naturopathic Oncology) have completed a post-graduate 4 year degree at an accredited institution, an oncology related internship in an accredited institution, plus 5 years of practice (some do an additional 2 year oncology residency in an American hospital because there is no Canadian equivalent), and finally, a set of board examinations that must be completed every 10 years.  OncANP (Oncology Association of Naturopathic Physicians) has a full listing of practitioners with this certification.   ND’s in Ontario are currently regulated under the BDDT-N (Board of Directors Drugless Therapy- Naturopathy), but are transitioning to a separate college, around the estimated date of August 2013 (The College of Naturopaths of Ontario).

 

Another concern of the conventional medical professionals is that although we are using evidence based medicine, the data we are using is not always the result of a large enough study, or wasn’t from a double blinded, placebo controlled trial.  Unfortunately, medicine is not always this black and white.  There are both good and bad research papers.  The job of the naturopathic oncologist is to assess the research, and make the decision based on the current best available evidence.  When a patient is seeing a naturopathic oncologist,  he or she is likely doing a variety of treatments such as acupuncture, lifestyle and dietary changes in addition to supplements.  The double blinded, placebo controlled trial does not fit this type of framework when assessing how effective treatment is.  The protocols within naturopathic oncology are multifaceted and it is quite typical for a number of treatments to be used simultaneously.

 

Problems in the current system

The current system doesn’t allow for proper communication between the conventional and adjunctive cancer care giver in some cases unless an oncologist wishes to individually collaborate.   Why is this?  ND’s are not currently part of the conventional medical system that is supported by our provincial government.    Without ND’s (trained specifically in these areas) working in the hospital, inconsistent information is given.  I believe it is imperative that ND’s work in the hospitals, as mainstream healthcare providers are not educated in the following:  acupuncture, herbal medicine, nutritional supplementation.  The professionals in the current system are already overburdened and cannot properly advise patients on what to do.

 

I am hopeful that in the future, ND’s can work alongside the other healthcare practitioners in a hospital setting.   Recently, the introduction of a pilot project affiliated with the teaching clinic of the CCNM and funded by the government at Brampton Civic Hospital is proving to be a lucrative investment.  The ideal system of the naturopathic oncologist working in the oncology centers may be a reality if this project is a success.

What is Integrative Oncology?

 


 

jillshainhouseJill Shainhouse, ND – CKN Integrative Medicine Section Co-Editor

Dr. Jill Shainhouse B.Sc, ND, FABNO is the founder of the Insight Naturopathic Clinic. She received her Honours Bachelor of Science degree from the University of Western Ontario prior to graduating from the Canadian College of Naturopathic Medicine.  Dr. Shainhouse was on staff at Toronto’s Medicor Cancer Centres as the naturopathic oncology consultant when the clinic first opened in 2007.

Dr. Shainhouse has a special interest in treating cancer and chronic disease.  With her mentor in 2007, she started the Adjunctive Cancer Care Program at the Canadian College of Naturopathic Medicine (CCNM).   She is currently the one of few naturopathic doctors in Ontario to obtain a specialized board certification in naturopathic oncology and maintains both a private practice in Toronto and also supervises at the Robert Schad Clinic in the CCNM.

Dr. Shainhouse’s goal in treating cancer patients is to provide safe and effective support during or after conventional therapies such as surgery, chemotherapy and radiation.

Dr. Shainhouse is additionally certified in intravenous therapy and has completed additional training in central vascular access and advanced parenteral therapy.  She is a member of the Ontario Association of Naturopathic Doctors, the Canadian Association of Naturopathic Doctors, the Oncology Association of Naturopathic Physicians. the Society for Integrative Oncology and the International Society for Orthomolecular Medicine.

 

 

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2 Responses to In a Perfect World: The integration of conventional and integrative oncology

  1. Pingback: Talking to cancer patients about complementary therapies: An Update - Cancer Knowledge Network

  2. Bruce Colwell says:

    Although Dr. Shainhouse addresses the issue of evidence based medicine she seems to dismiss the issue of levels of evidence that the naturopath seems to use “not a large enough study or not double blinded”. In Conventional medicine we have the same problems but we address the through levels of evidence. Some facts can only be established by “expert opinion” but that ranks much lower in the scales of evidence then several well conducted randomized controlled trials (level I evidence). The government does not pay for many treatments until we have a level of evidence that justifies the expenditure. It is costly and time consuming to do these studies but it allows use to take away bias of experts in the field. i realize that some treatments are multifactorial and not involve drugs funded by the pharmaceutical industry but this occurs in conventional medicine such as the physical activity studies that are being done in a number of cancer centers. The use of ginger as an antiemetic is an example of how a large randomized control trial can be conducted to show benefit of this product. We all try to do the best for the patient but funding for therapies need to be measured by the same scales of evidence and if it is justified by that scale then paid for

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